Improving Value-Based Care in New York

The Journey from Volume to Value” panel brought together prominent health care leaders to discuss the unique value-based care challenges in the New York market, as well as the catalysts needed for change on a national and local level.

Bunny Ellerin, Co-founder and President, NYC Health Business Leaders (NYCHBL), gave opening remarks and thanked Oliver Wyman for sponsoring, “Here at NYCHBL, we’re all about collaboration and breaking down silos in the health care ecosystem.” The organization’s mission aims to bring together the best minds to discuss important issues and spur innovation. “We’ve been successful because we want to put a mark in NYC where innovation in health care happens.”

Moderator Patrick Barlow, Health and Life Sciences Partner, Oliver Wyman, kicked off the panel discussion and set the stage with value-based reimbursement data and asked the audience, “How much of value-based care is sizzle and how much is it steak?”

Despite a handful of innovative breakthroughs, the New York market is trailing the nation in regards to value-based payment progression, so the necessary question remains: “What do we need to be pushing for?”

“In NYC fragmentation makes it challenging for value-based care to grow,” Noted Niyum Gandhi, EVP and Chief Population Health Officer, Mount Sinai Health System.

Shawn Fitzgibbon, EVP and Chief Product Officer, EmblemHealth, added, “The absence of large independent medical groups, the predominance of academic medical centers and broad network based plan designs, are challenges to grow value-based care in the New York market.”

Aside from the various challenges within the health care system, one of the most important notions to consider is the power of the consumer. “The experience for the member is paramount,” said Fitzgibbon. “For instance, if a health plan can’t improve the consumer experience, there will be a direct impact on quality scores, and its opportunity to optimize more value-based relationships.”

Providing educational information that encourages patient engagement can create an environment where the patient or member realizes how much health institutions are dedicated to their well-being and it will result in the exchange of health information more freely. Fitzgibbon commented, “That’s the place we need to get to — it’s bringing the member, patient, physician and payer into an aligned environment.”

The efficient flow of information and health data are integral components to successful value-based care models. Yet, Geraldine McGinty, MD, MBA, Assistant Chief Contracting Officer, Weill Cornell Medicine, noted, “Standardizing metrics is a frustration, and one of the major problems we need to solve and attack.” She added, “Overall, we need to find a health entity that will encourage innovation that isn’t on everyone’s radar.”


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